Population-based studies have shown that multisite musculoskeletal pain can be more common than single anatomic site pain. The consequences of multisite musculoskeletal pain are more severe when compared with single site pain in terms of short- and long-term sickness absence, work disability, and functional ability. Little is known, however, about what factors influence multisite musculoskeletal pain severity over time particularly in construction workers who are exposed to strenuous mental and hazardous physical work environments. In the construction workforce, there is a need for longitudinal studies with repeated measurements to better understand the occurrence and course of multisite musculoskeletal acute and chronic pain and its severity, as well as its association to occupational and non-occupational risk factors. For this three-year Mentored Research Scientist Development K-Award training period, and with the guidance of my K01 mentorship team, I propose the following training and research plan: 1) a strategic five prong training approach to learn how to design and implement workplace health interventions, and 2) as the research objective of this application, collect pilot data through a 1- year prospective cohort study on the occurrence of multisite musculoskeletal acute and chronic pain among construction workers. The research proposal has two specific aims: Specific Aim 1a: Design and implement a 1- year prospective cohort study of 350 New England construction workers that will use validated survey instruments, to measure the main outcome of self-reported musculoskeletal pain by anatomic location and pain severity, as well as occupational risk factors (i.e. physical workload, ergonomic use, organizational/worksite policies and practices) and non-occupational risk factors (i.e. worker health behaviors and demographics, health conditions, psychosocial factors) and absenteeism (secondary outcome measure) at baseline, 6-month and 12-month follow up time periods; Aim 1b: Document cohort study feasibility including metrics on the number and type of construction workers invited and recruited per construction site; the enrollment and retention of workers into the cohort study; and the loss to follow up in the cohort; and Aim 1c: Using the cohort data, I will provide comprehensive descriptive statistics and estimate the incidence and prevalence of multisite musculoskeletal acute and chronic pain location and severity overall at baseline, 6-month, and 12-month follow up. Specific Aim 2: Data collected from the cohort of construction workers will be used to estimate generalized linear mixed models to examine the prospective association between occupational and non-occupational risk factors at baseline on predicting the occurrence of self-reported multisite musculoskeletal pain location, severity and impact. The expected outcome of the proposed work is preliminary data to inform the design of an intervention that incorporates a NIOSH Total Worker Health framework to reduce musculoskeletal pain in construction workers. The results are expected to have an important positive impact on musculoskeletal health, because researchers can modify certain occupational and individual worker-level factors when integrating occupational health and safety activities with workplace health promotion.